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Your Tagovailoa Injury: The Surgeon's Expert View on Dislocated Hip, Surgery, Rehabilitation, Future Perspectives, and More



College Football Playoff and the 2020 NFL Draft had unexpected twists this weekend when Alabama quarterback Tua Tagovailoa suffered a devastating hip injury late in the season. The injury, a dislocated hip with a posterior wall fracture, occurred with 3:01 remaining before the break of the Red Tide game against the state of Mississippi. The defender rolled left and was spotted by two Bulldog defenders, who landed with all their body weight on Tagovailoa.

Coach Nick Saban revealed after the game that the goal was Tagovailoa's final game – Alabama led by 35 to 7 at the time – but he wanted to give him more exposure to the two-minute attack scenarios.

In a post-match statement, Alabama team orthopedic surgeon Dr. Lyle Cain provided an early prognosis: "Your Tagovailoa suffered a right hip dislocation that was immediately reduced at the stadium. He is undergoing further tests to determine the better course of treatment. He should make a full recovery but lose the rest of the season. "

This is a complex injury, with some remaining obstacles for Tagovailoa before he can return to the field. As such, CBS Sports spoke with Dr. Louis Levitt, who serves as vice president and secretary of the Advanced Orthopedics Centers in Washington, D.C.

"The problem is that we, as a lay audience, don't really know the extent of your injury. The injury itself is one of the few true orthopedic emergencies; besides breaking a bone and making the bone stand out from the skin, which didn't happen – that was the [Joe] Theismann's injury – for example, "Levitt explained.

"This was the case when when you dislocate your hip, you have a limited amount of time to put your hip back in the socket because it compromises the blood flow to the ball from the ball joint and the joint, hence the reason for the helicopter. to take him to a reasonable trauma center so they could reduce their hips, "Levitt continued.

"Once the hip is back in the socket, presumably perfectly aligned in the socket – and I presumably say because [that] we don't know – sometimes when you pull the ball back into its socket, it picks up some bone fragments. Therefore, you cannot leave it that way. You have to go surgically and remove the bone fragments.

"When the ball is back in place again, it will be necessary to evaluate through varying tests to what extent the socket is damaged and what you would have to do to stabilize the socket. Often, the most common form of this displacement is to remove part of the ball. snap when the ball moves. "

Levitt said this form of injury is unusual and is usually associated with violent car accidents.

"It takes tremendous force to dislocate a young player like this. Usually car accidents get your leg into the socket and then out of the socket. Often you break the socket," Levitt said. "I would speculate that, more than likely, he will need a surgical procedure to at least stabilize the socket: plates and screws to replace the parts. It's all speculation, because we really don't know the extent of the injury."

Tagovailoa will lose the rest of the 2019 season and potentially the whole of the 2020 season. Many are wondering if he will ever play football – at any level – again.

"The recovery for this, even in a healthy young person, is 6 to 12 months. I often go wrong next to 12 months," said Levitt. "Let's say everything goes perfectly and they can restore the anatomy, the bone recovers and it can begin its rehabilitation process. The second concern you have in the coming months is whether the blood supply to the ball has been compromised. the ball itself dies.

"So we tell Bo Jackson's story about why he ended up with avascular necrosis or femoral head AVN because he lost his blood supply. You can just have a dislocation, get it back quickly and lose it. You may not compromise the blood supply, but when you are going to fix the socket, you may need to pull the ball down or move the hip again while fixing the socket and this compromises an already challenged blood supply. two phases. They can anatomically rebuild the hip, allow him to heal? And then, will he undergo some form of ball deformity that leads to severe arthritis and potential hip replacement in the future, like Bo Jackson? "

The injury occurred around 13:30. ET on Saturday. Next week's events will be kept confidential, but Levitt offered his expectations.

"I think [as of late Sunday morning] they are evaluating him. They are probably doing a CT scan because that is the best way to look at the bone and they are evaluating soft tissue injury. Then they will determine – probably in a good trauma center sooner or later – [when] come in and fix it, "said Levitt." I would suspect it would be 48 hours to a week. Not every trauma center has doctors or orthopedics on board that are easy to do this kind of deep pelvic reconstruction. They may have to move it again. If he's in a level 1 trauma center where they do pelvic work, I wouldn't be surprised if he didn't have surgery within 48 to 72 hours. "

There may be neurological problems arising from the injury as well.

"So it's a matter of letting the wound heal, praying that he doesn't get an infection; he's young and healthy, I hope he doesn't. So it's the rehabilitation process," Levitt said.

"I talked about one of the complications, because he loses his blood supply and the ball dies in the long run – in the long run it's within a year, meaning years, you'll know that within a year. The other potential complication is that we don't know if he has any neurological damage. They will know that when they evaluate him … They will start the reconstruction and put him upright. They will not allow him to give weight to her, but make him move quite early. " .

Some injuries make athletes more likely to suffer a similar injury in the future. Levitt says Tagovailoa will no longer be vulnerable to a dislocated second hip than it was before Saturday's game.

"It's so rare. When you see all the major auto accidents and sports injuries, it's very rare. The chances of him returning to the same situation are very rare. Because he suffered the fracture for the first time, healing. With the plaque and the screws in place is actually a stronger socket in some ways, so I think his risks are not higher because he suffered a fracture. That's really the case with top athletes, "Levitt said.

"Bo Jackson played pro baseball after doing a hip replacement, and everyone thought it was the best thing since sliced ​​bread. He probably delayed hip replacement by about a decade, because everyone thought it could go to level. I think Jackson's hip loosened after 3-4 years and he had to make a second hip replacement and never recovered from it.

"That's why you expect it, the perfect scenario, the ball is back in the socket, there are no loose fragments in the socket, it's a single piece of the socket that can be easily replaced. It has no complications and so if all the gods shine on him, he will probably be able to play again and retain his professional potential within a year. "

If all goes according to the surgery, the focus shifts to the rehabilitation process.

"They will wait until the bone recovers. What they will do is gently flex and extend his hip with minimal hip rotation. They can start this within 10 days after surgery. Probably won't let him put it on." all the weight in it for at least 8 to 12 weeks. Then they put it in a pool early when the wound heals to put it in a non-gravitational environment and then the ground exercises really start to accelerate between 3 to 6 months. They won't allow him to play impact or pivoting sports easily, I think 4-6 months. "

As a junior, Tagovailoa faces the choice of either returning to Alabama for his senior season or leaving early for the 2020 NFL Draft. The deadline to declare is January 20, which would mean that the Hawaii native would spend about two months in a lawsuit. recovery potential for one year.

There are many variables at play, but Levitt said he would probably recommend Tagovailoa to stay out of the 2020 season, regardless of whether he is in high school or professional level.

"He has many obstacles ahead of him. I would err on the side of this young conservative. I could keep him out," Levitt noted, citing how conservative the Washington nationals were with Washington's recovery schedule. star pitcher Stephen Strasburg.

Most high-level college athletes are insured against loss of value as a safeguard against the loss of potential earnings in the event of catastrophic injury. Tagovailoa is believed to have this insurance.

Reasonably speaking, NFL teams will have difficulty selecting it where it was designed – the top five choices of NFL Draft 2020 – based on the unknowns of his injury. It wouldn't be a surprise or a bad decision if he chooses to return to his senior season simply to stay out, heal and prepare to play and exercise before the 2021 NFL Draft.

His brother, Taulia Tagovailoa, is a newbie in Alabama.

The older Tagovailoa had already lost a game this season with an ankle injury, which underwent a rigorous procedure. It was similar to the injury he sustained before the 2018 SEC Championship Game. He ended the year with 180 of 252 passes at 2,840 yards, 33 touchdowns and three interceptions.

Alabama turned to QB Mac Jones when Tagovailoa left the field. Crimson Tide continues to be part of the College Football Playoff conversation with two games remaining, including an Iron Bowl clash in Auburn last week. Jones has completed 45 of 65 passes for 566 yards, four touchdowns and one interception this season.


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